Discussing Life-Sustaining Treatment: A Teaching Program for Residents
Gordon, Geoffrey H.
Tolle, Susan W.
Archives of Internal Medicine. 1991 Mar; 151(3): 567-570.
Ideally, physicians and patients should discuss patient preferences for life-sustaining treatment before the onset of cognitive impairment or a life-threatening illness; however, these conversations often do not occur. We developed an educational program in which residents practiced discussing advance directives with volunteer simulated outpatients and then received feedback from the patient, an observing resident, and a faculty member. Residents found the training sessions to be realistic, relevant, and useful. Resident self-ratings improved significantly on eight items representing knowledge, skills, and attitudes about discussing advance directives with patients. Resident learning occurred in four major areas: technical knowledge about advance directives; introducing the topic to patients; giving patients information; and eliciting patients' values and feelings. We conclude that residents need and want training in this area and that simulated patients act as a catalyst for their learning.
Adults; Advance Directives; Aged; Allowing to Die; Ambulatory Care; Attitudes; Behavioral Research; Brain; Brain Death; Communication; Competence; Comprehension; Death; Disclosure; Education; Ethics; Evaluation; Evaluation Studies; Faculty; Health; Hospitals; Internal Medicine; Internship and Residency; Illness; Knowledge; Legal Aspects; Life; Medical Education; Medical Ethics; Medicine; Methods; Patients; Persistent Vegetative State; Physicians; Professional Competence; Professional Patient Relationship; Prognosis; Research; Residency; Survey; Teaching Methods; Treatment Refusal; Truth Disclosure; Values; Volunteers;
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The Consistency Between Treatments Provided to Nursing Facility Residents and Orders on the Physician Orders for Life-Sustaining Treatment Form Hickman, Susan E; Nelson, Christine A; Moss, Alvin H; Tolle, Susan W; Perrin, Nancy A; Hammes, Bernard J (2011-11)To evaluate the consistency between treatments provided and Physician Orders for Life-Sustaining Treatment (POLST) orders.
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